Syringe Confiscation as an HIV Risk Factor: the Public Health Implications of Arbitrary Policing in Tijuana and Ciudad Juarez, Mexico

Journal of Urban Health, Vol. 90, No. 2, pp. 284-298, 2013

Northeastern University School of Law Research Paper No. 90-2012

Posted: 12 May 2012 Last revised: 1 Apr 2013

Leo Beletsky

Northeastern University - School of Law; Northeastern University - Bouvé College of Health Sciences

Remedios M. Lozada

Patronado Pro-COMUSIDA

Tommi Gaines

University of California, San Diego – School of Medicine, Division of Global Public Health

Daniela Abramovitz

University of California, San Diego – School of Medicine, Division of Global Public Health

Hugo Staines

Universidad Autonoma de Ciudad Juarez

Alicia Vera

University of California, San Diego (UCSD) - School of Medicine

Gudelia Rangel

US-Mexico Border Commission

Steffanie A. Strathdee

University of California, San Diego – School of Medicine, Division of Global Public Health

Jaime Arredondo

University of California, San Diego – School of Medicine, Division of Global Public Health

Date Written: May 10, 2012

Abstract

Female sex workers who inject drugs (FSW-IDUs) face elevated risk for HIV/STIs and constitute a key population for public health prevention. Through direct and indirect pathways including human rights violations, policing practices like syringe confiscation can compound FSW-IDU health risk and facilitate the spread of disease. We studied correlates of experiencing syringe confiscation among FSW-IDUs in northern Mexico, where formal policy allows for syringes to be available over-the-counter without a prescription, but police practices are often at odds with the law. FSW-IDUs reporting recent syringe sharing and unprotected sex with clients in Tijuana and Ciudad Juarez were administered surveys and HIV/STI testing. Logistic regression was used to identify correlates of syringe confiscation. Among 624 respondent FSW-IDUs, prevalence of syringe confiscation in the last 6 months was 48%. The following factors were positively associated with syringe confiscation: testing positive for HIV (adjusted odds ratio [aOR]=2.54, 95% confidence interval [CI]=1.11-5.80), reporting sexual abuse by police (aOR=12.76, 95%CI=6.58-24.72), engaging in groin injection (aOR=1.84, 95%CI=1.15-2.93), injecting in public (aOR=1.64; 95%CI=1.14-2.36), and obtaining syringes from pharmacies (aOR:1.54; 95%CI=1.06-2.23). Higher education level was negatively associated with syringe confiscation (aOR=0.92, 95%CI=0.87-0.98) as was frequent injection with clients within the last month (aOR=0.64, 95%CI=0.44-0.94). This analysis adds to the body of evidence linking unauthorized law enforcement actions targeting high-risk groups with HIV and other adverse health outcomes. Using a public health lens to conceptualize abuse as a structural risk factor, we advocate for multi-prong prevention, systematic monitoring, and evidence-based intervention response to deleterious police practices.

Suggested Citation

Beletsky, Leo and Lozada, Remedios M. and Gaines, Tommi and Abramovitz, Daniela and Staines, Hugo and Vera, Alicia and Rangel, Gudelia and Strathdee, Steffanie A. and Arredondo, Jaime, Syringe Confiscation as an HIV Risk Factor: the Public Health Implications of Arbitrary Policing in Tijuana and Ciudad Juarez, Mexico (May 10, 2012). Journal of Urban Health, Vol. 90, No. 2, pp. 284-298, 2013; Northeastern University School of Law Research Paper No. 90-2012. Available at SSRN: https://ssrn.com/abstract=2055746

Leo Beletsky (Contact Author)

Northeastern University - School of Law; Northeastern University - Bouvé College of Health Sciences ( email )

416 Huntington Avenue
Boston, MA 02115
United States
617-373-5540 (Phone)

Remedios M. Lozada

Patronado Pro-COMUSIDA ( email )

Mexico

Tommi Gaines

University of California, San Diego – School of Medicine, Division of Global Public Health ( email )

9500 Gilman Drive
MC 0507
La Jolla, CA 92093
United States

Daniela Abramovitz

University of California, San Diego – School of Medicine, Division of Global Public Health ( email )

9500 Gilman Drive
MC 0507
La Jolla, CA 92093
United States

Hugo Staines

Universidad Autonoma de Ciudad Juarez ( email )

Calle Henry Dunant
Ciudad Juarez, Chihuahua 32310
Mexico

Alicia Vera

University of California, San Diego (UCSD) - School of Medicine ( email )

9500 Gilman Drive
MC 0507
La Jolla, CA 92093
United States

Gudelia Rangel

US-Mexico Border Commission ( email )

Tijuana
Mexico

Steffanie A. Strathdee

University of California, San Diego – School of Medicine, Division of Global Public Health ( email )

9500 Gilman Drive
Mail Code 0502
La Jolla, CA 92093-0112
United States

Jaime Arredondo

University of California, San Diego – School of Medicine, Division of Global Public Health ( email )

9500 Gilman Drive
MC 0507
La Jolla, CA 92093
United States

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